Letter: Let’s Talk Health, Not Dollars

I hope I am not the only one who could barely make it through the Bloomberg News editorial published in the Dec. 10 Valley News (“Scheduled Deliveries”) without sputtering in disbelief. I completely understand the national obsession with the high costs of health care and applaud those who are trying valiantly to contain those costs, but I just wish that the driving factors to reduce non-medically indicated scheduled births were the health and well-being of mothers and babies — not the dollars. Discussions about reducing Medicaid payments to “discourage unnecessary surgeries” or awarding millions of dollars to hospitals who reduce “optional early births” seem to be totally missing the point.

How is it that providers have been allowed to perform unnecessary surgeries in the first place? Where are the medical staff monitoring committees? Where are the clinical indicators for medically necessary C-sections? Where are the peer review committees’ reviews of surgical procedures performed without medical indication? Where are the health care staff who should be advocating for the safety and health of mother and baby above all else? Why are parents-to-be not fully informed of all the risks of major surgery, no matter how convenient it may be for busy parents or providers? How much balanced information is given to parents about the possibility of vaginal birth after C-section? Is it all about the money?

For most of the 1980s, I worked as a certified child-birth educator both in the U.S. and Italy and we lobbied back then to reduce C-section rates. I have been away from that specialty for well over 20 years, and now here it is 2012 and the situation is worse than ever. I beseech mothers- and fathers-to-be to question any decision to schedule, induce or otherwise interfere with the normal process of labor and delivery. And when you get the answers, dig deeper and question some more. It is your right as a patient to be a full partner in your care. Make sure you fully understand the clear, definitive reason for any medical intervention. And then, when you are completely satisfied, trust that your provider will deliver the best care possible ... and the cutest baby ever born.

The evidence has been in for some time. Scheduling births may be convenient for physicians, hospitals and expectant parents, but it generally isn’t good for the health of mothers and children. It’s expensive to boot. To get a baby to arrive on schedule, doctors often perform a cesarean section, the most common surgery in the United States. Since 1996, C-section …